When Barrett Rollins walked into the bathroom of his Beacon Hill home, he was stunned to find his wife lying on the uneven tile floor covered in blood.
Rollins and his wife, Jane Weeks, were physicians and researchers at Dana-Farber Cancer Institute and lived steps from some of the world’s best hospitals. But Weeks didn’t want medical help. Instead, without looking at her husband, she calmly explained that she was dying.
She reluctantly told him what she had inexplicably never shared: that she had advanced breast cancer. Now the cancer had spread to a blood vessel and burst through her skin.
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“I raised my voice [and said], ‘You have to see somebody’,” Rollins recalled. But Weeks was adamant. “If you ever talk about this again,” she told him. “I’ll never forgive you.”
Afraid she would leave him, Rollins agreed.
That was in 2008. Eventually, Rollins had to come to terms with another devastating secret: His wife had hidden her breast cancer from him for six years. Together, the pair would continue to conceal her illness from family, friends, and colleagues until she was hospitalized in 2012. Weeks died in 2013 at age 61.
The mystery of how Rollins succumbed to Weeks’s resolute denial, and why he helped his wife avoid treatment for the malady which would kill her is at the center of Rollins’s memoir, “In Sickness,” to be published Tuesday by Post Hill Press.
The book marks Rollins’s effort to reclaim the narrative Weeks insisted on hiding. For readers, he hopes the book tells a different kind of cancer story, away from the pink ribbons and images of the tough cancer “fighter.” The labels were ones Weeks had combated, as she believed they fooled patients into believing they could face down an implacable foe.
“I thought of myself as being incredibly loyal and devoted,” Rollins said in an interview. “Soon after she died, I looked back at that and thought, ‘I knew my wife had metastatic cancer. I knew she could get treatments that would help her — maybe not make her live longer but improve her quality of life. And I couldn’t find a way to do it.’”
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The book, he said, was his attempt to understand what happened — to both of them.
At 6 feet tall, Weeks’s lanky frame commanded attention, but it was her intellect that drew people in. She spoke with a mix of wit and sharp-edged candor that was as intoxicating as it could be wounding.
Engaging with her felt like playing with fire, said Rollins. It required your full attention, lest she lose interest — or burn you with criticism.
To be in her gravity field felt like a privilege.
“The fact that she wasn’t bored by me means more to me than my professorship at Harvard Medical School,” said Dr. Thomas Lee, chief medical officer for a patient satisfaction survey company and a longtime friend of Weeks. “There are lots of professors at Harvard, there weren’t a whole lot of people who weren’t boring to Jane.”
Part of Weeks’s allure was that her brilliance and humor were wrapped in a dark complexity. Lee said there was always a side of her that was out of reach, pieces of herself she wasn’t going to share.
But what she did share felt like enough. Weeks could use her intellect generously, giving masterful advice and teasing out a person’s strengths to propel them forward. And she was fun. Over dinner, she would sometimes make it a game to dissect people’s personalities. She would command the conversation as friends debated whether someone was intelligent and bookish, cunning and calculating, both, or neither.
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She was a celebrated researcher who published more than 100 papers and had a way of assessing things in a new light, bringing clarity and organization to subjects that would otherwise seem overwhelming. The skills suited her well academically. She was admitted to Harvard Law School but never went, pivoting instead to do a post-baccalaureate pre-med program at Harvard. She was accepted to Harvard Medical School and, toward the end of her residency, chose to specialize in oncology.
Colleagues credit her with creating a new field, analyzing whether cancer treatments meaningfully improve the quality of someone’s life, and not just its length. She established and led a center at Dana-Farber devoted to it. Throughout her career, she was intent on a stark honesty with patients, pressing for doctors to advise them on what chemotherapy could and could not do so they could decide whether they wanted treatment at all.
Weeks would publish an influential paper in 2012 showing that two-thirds of people with incurable metastatic cancers believed their doctors had told them chemotherapy could be effective against their disease. Those with this understanding rated their doctors as better communicators. The findings underscored a level of denial on the part of patients, in which doctors were co-conspirators, Weeks thought. Chemotherapy may occasionally extend the lives of these desperately ill patients, but often not for long, and at a cost.
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Her views may have been shaped by watching her father, an English professor at the University of Michigan, succumb to advanced prostate cancer after a couple of ineffective rounds of therapy when Weeks was a medical resident. Soon after she became a faculty member at Dana-Farber, Weeks stopped caring for patients, fretful that she would provide her patients with drugs that might make them sicker.
Weeks pointed out often to Rollins and to other oncologists, in lectures and in her research, that dying was not the worst fate someone could conjure. A life lived with paralysis, dementia, or chronic pain could be worse. Weeks herself knew she wouldn’t want to experience the suffering that chemotherapy can inflict on dying patients, Rollins writes.
In fact, Weeks found the idea of being weak revolting. Instead, she had adopted a veneer of strength.
“When she was chief resident at the Brigham, the interns and residents had a picture [with] a caption that said, ‘Jane Weeks eats nails for breakfast.’ And she loved that,” Rollins said.
Her cancer presented a horrific exception to her self-image, and she refused to broadcast to the world a frailty that might be met with pity.
Weeks especially hated the stereotypes many cancer patients were forced to don, in particular the idea of the “brave fighter.” Bravery in the face of metastatic cancer set up a person for cruel disappointment, Weeks thought.
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Weeks once told Dr. Thomas Lee’s wife that if she were ever diagnosed with melanoma, she would do nothing about it. Nature would take its course.
“But that isn’t what she did,” Lee said. “She didn’t just let cancer take its course. She tried to treat it.”
But not until far too late.
In the 30 years Rollins knew her, Weeks never went to a doctor or dentist appointment, relenting once when she had a root canal. She skipped all forms of routine tests, screenings, and exams.
Not that she lived without pain. Lower back pain and sciatica were companions for years. For a time, Weeks had recurring attacks of fever and excruciating abdominal pain that kept her out of work. Yet despite Rollins’s pleas, she refused to seek care, and instead prescribed herself antibiotics.
Rollins never knew the root of her medical phobias. All he understood were the effects.
“Being smart is not an antidote to psychopathology,” said Dr. Deb Schrag, chair of the Department of Medicine at Memorial Sloan Kettering Cancer Center, and a longtime mentee of Weeks who succeeded her as division chief at Dana-Farber. “People are complicated and they have demons.”
There was also no reasoning with Weeks when she made up her mind. She could be immovable, decidedly set in her ways. She had rules at the lunch table, where the same group gathered daily as Weeks held court. She encouraged a spirited exchange of ideas, but no matter what, they weren’t allowed to talk about science.
“She could just make up her mind about some arbitrary thing, and that’s it. You couldn’t change her mind,” said Dr. Michael Robertson, director of the lymphoma program at Indiana University School of Medicine, who had been friends with Weeks since they trained together as fellows at Dana-Farber.
Weeks stubbornly refused care until 2012, when she nearly died at work. Rollins and Weeks were walking as always to eat lunch together. But that day, Rollins noticed Weeks’s gait had slowed. Her lips had begun to turn blue, and she began gasping for breath. Alarmed, he suggested they go to the ER at Brigham and Women’s Hospital next door. He was perhaps more alarmed when Weeks agreed.
By the time he had returned from trying to find a wheelchair, Weeks was sprawled on a small bench, moaning with each breath. Someone called a hospital code, and then an ambulance, which rushed Weeks to the ER.
There, scans showed that the cancer had caused a giant blood clot in her lungs. The cancer itself was anchored to her chest wall and had laid claim to her liver, lungs, ribs, and sternum.
Hooked to a breathing tube, IVs, and a monitor, there was no denying the cancer any longer. A black, irregularly shaped mass had replaced what was once her right breast. Rollins initially thought someone had left a piece of black medical equipment on his wife’s body. It was the size of a football, and was infected.
Though Rollins began telling some select friends and family that Weeks had collapsed and had cancer, she would forbid him from telling people the full story.
Friends were shocked to eventually learn that Weeks was dying. Trained oncologists themselves, the story didn’t make sense. Postmenopausal women rarely first present with breast cancer that has spread throughout their bodies. Weeks was a slight woman who would likely have noticed a lesion in her breast early on. Friends deduced, correctly, that Weeks had ignored her own breast cancer and let it spread.
Dr. Christopher Slapak, associate clinical professor of medicine at Indiana University School of Medicine who was also a close friend of Weeks, called Rollins a few weeks after the collapse and gently asked — did Weeks have a breast cancer she was ignoring? Rollins wouldn’t answer at first, despite the fact that Slapak and Robertson, his spouse, were the couple’s best friends. But finally on the phone, Rollins admitted the truth — yes, she did.
Weeks regained strength in the coming days, and Rollins went about preparing their home for her care, organizing things in Weeks’s room that he had long stopped sleeping in. He had understood since that day in 2007 that withholding intimacy for years was one way she had been able to hide her illness from him.
The spool of Weeks’s secrets continued to unravel as he went about the work. Opening a drawer in her room, Rollins discovered dozens of pill bottles, some filled with powerful chemotherapy drugs and estrogen blockers, all prescribed by Weeks for herself. Yet she wasn’t doing the necessary monitoring to make sure the drugs themselves wouldn’t kill her.
Rollins views her decision to treat herself, albeit haphazardly, as a partial acceptance of her disease.
“I think she always knew she was going to die of this,” he said. “And I think that she started taking those treatments to see if maybe she could delay it.”
As the cancer progressed, Weeks became more open to other therapies. In her final months, Weeks considered surgery to improve her quality of life, but the cancer had progressed too far. While still reluctant to try standard chemotherapy, she tried an experimental drug not yet approved by the FDA. Weeks received compassionate use approval from the company and the FDA to take the treatment, but it failed to inhibit the cancer’s growth.
A month after her collapse outside the ER, Weeks published research showing patients with advanced cancer didn’t understand that their chemotherapy wouldn’t cure them. She feared doctors’ reluctance to take away false hope prevented people from having end-of-life discussions early.
She never wanted to be one of those doctors, or patients. And yet for months, Weeks herself didn’t have those end-of-life discussions.
Instead, as the disease progressed, Weeks dreamed of returning to work, and did so remotely for months. Ultimately, though, her absence began to affect the department, and, reluctantly, Weeks handed over the reins to Schrag, who promised the division would remain Weeks’s as long as she was alive.
Weeks died at home in September 2013. In news stories about her death, some of the deception around her illness remained — Rollins continued to say she had only known about her illness for a year.
Her legacy now remains in the hands of those who have carried it on, friends and colleagues say, and in the canon of her work.
Rollins, who is now senior adviser to Dana-Farber’s president and CEO, has remarried and has in many ways moved on from the past.
But hard questions about Weeks’s decision remain.
Slapak, one of Weeks’s closest friends, noted that for leaders in oncology, part of the job is to encourage patients to seek care and be seen early. Why Weeks would choose not to do so herself still baffled him a decade later.
To Schrag, the essence of Weeks was in that duality — that her brilliance and irreverence could sit side by side with a decision that ultimately killed her.
Others see the tale, and Rollins’s uncommon role in it, as a kind of love story. Lee recalled that in medical school, a psychoanalyst told him that love is a conspiracy of two people to create a shared unreality.
“It sounds dark. But you support each other’s fantasies, and live in a world that is not completely rational or honest,” Lee said. “It’s a conspiracy and you sustain it.”
At the least, friends say they will be thinking and talking about her decision for the rest of their lives. Weeks loved to ponder existential questions her entire career, in all their complexity and nuance. Fittingly, she left a complex puzzle behind.
“Jane would have had a more thoughtful, brilliant analysis of the Jane Weeks story than anyone I know,” Lee said. “It’s a shame she can’t pick it apart for all of us.”
Jessica Bartlett can be reached at jessica.bartlett@globe.com. Follow her on Twitter @ByJessBartlett.